title: Pregnancy complications and obstetric care in women with inherited bleeding disorders.
abstract: Women with inherited bleeding disorders (IBD) require the input of a multidisciplinary team to improve outcomes of pregnancy. The role of the haemophilia nurse within the multidisciplinary team is to provide educational and emotional support to the women and to facilitate and co-ordinate patient-centred care. Prenatal diagnosis in cases of haemophilia is an integral part of the management of early pregnancy with a recent drive towards non-invasive prenatal diagnostic techniques. There is a current lack of data on the risk of miscarriage and bleeding complications during pregnancy. A clear association has only been established in women with fibrinogen and factor XIII deficiency. In the affected neonate with severe bleeding disorders such as haemophilia, the risk of head bleeding is significant, and appropriate management of labour and delivery has an important impact on reducing the risk. Women with IBD are at risk of both primary and secondary postpartum haemorrhage. Appropriate risk assessment and advance planning for haemostatic cover can reduce the bleeding risk.
authors.affiliation: Haemophilia Centre and Thrombosis Unit, Royal Free Hospital, London, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Kadir
authors.forename: J
authors.initials: J
authors.lastname: Davies
authors.forename: R
authors.initials: R
authors.lastname: Winikoff
authors.forename: D
authors.initials: D
authors.lastname: Pollard
authors.forename: F
authors.initials: F
authors.lastname: Peyvandi
authors.forename: I
authors.initials: I
authors.lastname: Garagiola
authors.forename: I
authors.initials: I
authors.lastname: Pabinger
authors.forename: A B
authors.initials: AB
authors.lastname: Federici
mesh_terms: D025861:Blood Coagulation Disorders, Inherited / Q000150:complications*; D003695:Delivery of Health Care; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D009773:Obstetric Nursing; D010346:Patient Care Management; D006473:Postpartum Hemorrhage; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000188:drug therapy*; D011296:Prenatal Diagnosis
keywords: haemophilia; labour; multidisciplinary team; pregnancy; prenatal diagnosis